RESUMO
Nutritional deficit of omega-3 long-chain polyunsaturated fatty acids (omega-3 LCPUFA), mainly eicosapentaenoic acid and docosahexaenoic acid, in the western population due the low consumption of marine products is actually a matter of concern. The classical alternative is the development of products with fish oil containing triglycerides rich in omega-3 LCPUFA: fish oil as such, encapsulated, microencapsulated or nanoencapsulated. However, independently of such procedures, reversion of taste and odor is always produced, avoiding its consumption. Phospholipids from marine origin are at present a more interesting alternative and of major nutritional impact than triglycerides for supplement omega-3 LCPUFA. These natural products have high concentration of omega-3 LCPUFA, mainly docosahexaenoic acid, are also more stable to oxidation and of higher bioavailability than triglycerides, and in addition provide other nutrients having nutritional benefits. However, at present industrial alternatives to obtain marine phospholipids are limited and probably subjected to future regulations or restrictions. This work analyzes the main advantages of marine phospholipids compared to triglycerides as source of omega-3 LCPUFA, the main sources for these nutrients, such as oils obtained from crustaceous, fish meal or by-products from aquaculture, and the future alternatives to provide the pharmaceutical, nutraceutical and food industry phospholipids from marine origin rich in omega-3 LCPUFA.
El déficit nutricional de ácidos grasos omega-3 de cadena larga (AGPICL omega-3), especialmente de ácido eicosapentaenoico y ácido docosahexaenoico en la población occidental debido al bajo consumo de productos del mar, es motivo actual de preocupación. La alternativa más clásica es el desarrollo de productos que contengan aceite de pescado conteniendo triglicéridos con alto contenido de AGPICL omega-3 en diferentes modalidades; aceite como tal, encapsulado, microencapsulado, o nanoencapsulado. Sin embargo, en cualquiera de estas modalidades, siempre se produce la reversión del olor y sabor, impidiendo así su consumo. Actualmente, los fosfolípidos de origen marino representan una alternativa mucho más interesante y de mayor impacto nutricional para suplementar AGPICL omega-3. Estos productos naturales presentan altas concentraciones de AGPICL omega-3, principalmente de ácido docosahexaenoico, son más estables a la oxidación, de mayor biodisponibilidad que los triglicéridos y además aportan otros nutrientes derivados de su estructura, también beneficiosos para la salud. Sin embargo, las alternativas para la obtención de fosfolípidos marinos a nivel industrial son actualmente pocas y posiblemente sujetas a control o restricción futura. Este trabajo analiza las principales ventajas de los fosfolípidos marinos en relación a los triglicéridos derivados del aceite de pescado como aporte de AGPICL omega-3, las principales fuentes de estos nutrientes, como lo son algunos aceites obtenidos de crustáceos, la harina de pescado o los subproductos de la acuicultura, y las futuras alternativas de desarrollo para proveer a la industria farmacéutica, nutracéutica y de alimentos AGPICL omega-3 a partir de fosfolípidos marinos.
Assuntos
Humanos , Fosfolipídeos , Óleos , Ácidos Graxos Ômega-3 , Recursos Marinhos , Aquicultura , Ciências da NutriçãoRESUMO
BACKGROUND: Quality indicators are tools used to monitor specific activities within a process and improve it. In the area of clinical laboratories, the National Accreditation Standards for Providers of Health and the ISO 15189 standard recommend the implementation of indicators that monitor the test cycle with emphasis on those that contribute to a safer health care. AIM: To describe the implementation of nine indicators in a hospital clinical laboratory and their measurement during one year. MATERIAL AND METHODS: The indicators implemented and measured were four of the pre-analytical phase (number of rejected samples, times of transport, blood culture contamination and blood cultures inoculated with adequate blood volumes), two of the analytical phase (coherence of Gram stains of blood culture with microorganism cultured and correct results in external quality control surveys) and three of the post-analytical phase (compliance with order to report lapse goals, corrected reports and alert values report). RESULTS: Two indicators of pre-analytical phase did not meet the per determined targets: number of rejected samples and blood cultures inoculated with adequate blood volume. All indicators of the analytical and post analytical phases were within the pre-determined targets. CONCLUSIONS: Coordinated work should be initiated especially with the nursing service to correct the two indicators that did not meet the target. The incorporation of quality indicators to monitor critical processes within the laboratory was undoubtedly an opportunity to identify areas for improvement.
Assuntos
Laboratórios Hospitalares/normas , Indicadores de Qualidade em Assistência à Saúde , Acreditação/organização & administração , Serviço Hospitalar de Emergência/normas , Hospitais Universitários , Humanos , Garantia da Qualidade dos Cuidados de Saúde/normasRESUMO
Background: Quality indicators are tools used to monitor specific activities within a process and improve it. In the area of clinical laboratories, the National Accreditation Standards for Providers of Health and the ISO 15189 standard recommend the implementation of indicators that monitor the test cycle with emphasis on those that contribute to a safer health care. Aim: To describe the implementation of nine indicators in a hospital clinical laboratory and their measurement during one year. Material and Methods: The indicators implemented and measured were four of the pre-analytical phase (number of rejected samples, times of transport, blood culture contamination and blood cultures inoculated with adequate blood volumes), two of the analytical phase (coherence of Gram stains of blood culture with microorganism cultured and correct results in external quality control surveys) and three of the post-analytical phase (compliance with order to report lapse goals, corrected reports and alert values report). Results: Two indicators of pre-analytical phase did not meet the per determined targets: number of rejected samples and blood cultures inoculated with adequate blood volume. All indicators of the analytical and post analytical phases were within thepre-determined targets. Conclusions: Coordinated work should be initiated especially with the nursing service to correct the two indicators that did not meet the target. The incorporation of quality indicators to monitor critical processes within the laboratory was undoubtedly an opportunity to identify areas for improvement.
Assuntos
Humanos , Laboratórios Hospitalares/normas , Indicadores de Qualidade em Assistência à Saúde , Acreditação/organização & administração , Serviço Hospitalar de Emergência/normas , Hospitais Universitários , Garantia da Qualidade dos Cuidados de Saúde/normasRESUMO
OBJECTIVE: To evaluate the reliability of two- and three-dimensional ultrasonographic measurement of the thickness of the lower uterine segment (LUS) in pregnant women by transvaginal and transabdominal approaches. METHODS: This was a study of 30 pregnant women who had had at least one previous Cesarean section and were between 36 and 39 weeks' gestation, with singleton pregnancies in cephalic presentation. Sonographic examinations were performed by two observers using both 4-7-MHz transabdominal and 5-8-MHz transvaginal volumetric probes. LUS measurements were performed using two- and three-dimensional ultrasound, evaluating the entire LUS thickness transabdominally and the LUS muscular thickness transvaginally. Each observer measured the LUS four times by each method. Reliability was analyzed by comparing the mean of the absolute differences, the intraclass correlation coefficients, the 95% limits of agreement and the proportion of differences < 1 mm. RESULTS: Transvaginal ultrasound provided greater reliability in LUS measurements than did transabdominal ultrasound. The use of three-dimensional ultrasound improved significantly the reliability of the LUS muscular thickness measurement obtained transvaginally. CONCLUSIONS: Ultrasonographic measurement of the LUS muscular thickness transvaginally appears more reliable than does that of the entire LUS thickness transabdominally. The use of three-dimensional ultrasound should be considered to improve measurement reliability.
Assuntos
Cesárea , Imageamento Tridimensional/métodos , Complicações na Gravidez/diagnóstico por imagem , Ruptura Uterina/diagnóstico por imagem , Útero/diagnóstico por imagem , Adulto , Feminino , Humanos , Imageamento Tridimensional/instrumentação , Variações Dependentes do Observador , Gravidez , Medição de Risco , Ultrassonografia Pré-Natal/métodos , Nascimento Vaginal Após Cesárea , Adulto JovemRESUMO
OBJECTIVE: To determine the validity and the intra- and interobserver reliability of volume measurements of an endometrium-like model using a three-dimensional (3D) ultrasound rotational technique. METHODS: A 3D ultrasound dataset was obtained from a sample of bovine liver containing a portion of chicken chest muscle (CCM). The process was repeated seven times using pieces of CCM of different sizes, resulting in seven datasets. Each portion of CCM was then placed in a water-filled volume-scaled tube and the 'actual' volumes were calculated by water displacement. For each dataset, ten volumes were calculated by each of two observers using a (VOCAL) with a 15 degrees rotational step. Reliability was assessed by calculating intraclass correlation coefficients (ICC) and validity by examining the percentage difference from the actual volume using limits of agreement. RESULTS: The volume measurement of organic tissues using the 3D ultrasound rotational method was highly reliable (intraobserver ICC, 0.998 for Observer 1 and 0.997 for Observer 2; interobserver ICC, 0.997) and valid (the bias and 95% limits of agreement of the percentage difference from the actual volume was only 0.57 (-3.07 to 4.21) % for Observer 1 and - 0.17 (-4.34 to 4.0) % for Observer 2). CONCLUSIONS: The 3D sonographic measurement, using VOCAL with a 15 degrees rotational step, of small and irregular tissues is reliable and valid, suggesting that it is a useful technique for measurement of the endometrial volume and other volumes of similar size.
Assuntos
Endométrio/diagnóstico por imagem , Imageamento Tridimensional/normas , Ultrassonografia Pré-Natal/normas , Animais , Aves , Bovinos , Galinhas , Feminino , Imageamento Tridimensional/instrumentação , Imageamento Tridimensional/métodos , Fígado , Modelos Biológicos , Músculo Esquelético , Gravidez , Reprodutibilidade dos Testes , Ultrassonografia Pré-Natal/instrumentação , Ultrassonografia Pré-Natal/métodosRESUMO
El pie paralítico fláccido tiene como deformidades más frecuentes el equino, varo y marcha en "steppage". Existen múltiples tratamientos quirúrgicos. Recientemente, Rodríguez describe una modificación del procedimiento de "Bridle", en el cual el tibial posterior es transferido al dorso del pie, con inserción ósea en la cuña media y tenodesado con el peroneo longus y el tibial anterior, a modo de "rienda" balanceada con tracción en tres puntos. Objetivos: Evaluar el resultado funcional de pacientes con pie paralítico fláccido flexible y semiflexible operados con procedimiento de "Bridle" modificado. Material y método: Evaluación retrospectiva de pacientes con pie paralítico fláccido tratados con técnica de "Bridle" modificado en el Hospital Clínico PUC entre agosto/2000 y abril/2004. Resultados:6 pacientes, 4 hombres y 2 mujeres, con 6 pies operados. Edad promedio de 27,6 (18-37) años. Seguimiento promedio de 26 meses. AOFAS pre/post cirugía: 32/76. Satisfacción completa en todos los pacientes (escala Kenneth-Johnson). Cinco pacientes regresaron a trabajar. Retorno parcial a actividad deportiva en 3 de 4 pacientes. Complicaciones locales en 1 caso; sin complicaciones sistémicas. Conclusión: existen pocas publicaciones sobre este procedimiento; nuestros resultados son comparables con la literatura. El procedimiento de "Bridle" modificado permite obtener un pie funcional, estable y plantígrado, con satisfacción completa en todos los pacientes.
Assuntos
Humanos , Masculino , Feminino , Adulto , Doenças do Pé/cirurgia , Paralisia/cirurgia , Paralisia/etiologia , Transferência Tendinosa , Transferência Tendinosa/métodosRESUMO
El diagnóstico rápido de microorganismos presentes en fluidos corporales estériles es de gran importancia clínica. La tinción de Gram constituyela principal herramienta para el diagnóstico de estas infecciones, pero la sensibilidad de está técnica varía segín el tipó de muestray la carga bacteriana presente en ella. La concentración de la muestra previa a la tinción, mejora el rendimiento pero requiere volúmenes significativos de la muestra. La citocentrifugación resulta útilya que requiere de escaso volumen de muestra y permite obtener preparaciones uniformemente concentradas. Con el objetivo de evaluar la cito centrifugación en el diagnóstico de fluidos corporales, se estudiaron 52 muestras de fluidos de cavidades estériles recividas en el Laboratorio de Urgencia del Servicio de Laboratorios Clínicos de la Red de Salud UC. Las muestras fueron separadas para centrifugación convencional (CC) a 3000 rpm por 5 minutos (centrifuga Jouan CR3i r) y para citocentrifugación (CT) a 2000 rpm por 10 minutos (Citocentrifuga Cytospin Shandon Inc r). Del sedimento obtenido por CC se realizó un frotis para tición de Gram y cultivo. De la CT se obtuvo una mono capa celular concentrada en un área de 6 mm de diámetro para tinción de Gram. Ambos frotis fueron leídos por el mismo observador. De las 52 muestras analizadas, 18 fueron sugerentes de infección clínica. La sensibilidad para CT v CC fue de 89 por ciento y 61 por ciento, respectivamente. La especificidad fue de 100 por ciento para ambas técnicas. En una evaluación cuantitativa de la celularidad de las muestras, se observó un aumento de los leucocitos en la CT con respecto a CC. Estos resultados muestran que la CT puede ser de gran ayuda en el diagnóstico rápido de las infecciones de fluidos corporales con baja carga bacteriana. Presenta una mayor sensibilidad y facilita la visualización de bacterias, especialmente en muestras con bajo recuento celular
Assuntos
Humanos , Centrifugação/métodos , Líquidos Corporais/microbiologia , Técnicas de Laboratório Clínico , Meios de Cultura , Sensibilidade e EspecificidadeRESUMO
A new papain-like cysteine peptidase isolated from fruits of Pseudananas macrodontes (Morr.) Harms, a species closely related to pineapple (Ananas comosus L.), has been purified and characterized. The enzyme, named macrodontain I, is the main proteolytic component present in fruit extracts and was purified by acetone fractionation followed by anion-exchange chromatography. Separation was improved by selecting both an adequate pH value and a narrow saline gradient. Optimum pH range (more than 90% of maximum activity with casein) was achieved at pH 6.1-8.5. Homogeneity of the enzyme was confirmed by bidimensional electrophoresis and mass spectroscopy (MS). Molecular mass of the enzyme was 23,459 (MS) and its isoelectric point was 6.1. The alanine, glutamine, and tyrosine derivatives were strongly preferred when the enzyme was assayed on N-alpha-CBZ-l-amino acid p-nitrophenyl esters. The N-terminal sequence of macrodontain (by comparison with the N-terminus of 30 plant proteases with more than 50% homology) showed a great deal of sequence similarity to the other pineapple-stem-derived cysteine endopeptidases, being 85.7, 85. 2, and 77.8% identical to comosain, stem bromelain, and ananain, respectively. It seems clear that the Bromeliaceae endopeptidases are more closely related to each other than to other members of the papain family, suggesting relatively recent divergence.
Assuntos
Cisteína Endopeptidases/química , Frutas/química , Sequência de Aminoácidos , Cromatografia por Troca Iônica , Cisteína Endopeptidases/isolamento & purificação , Inibidores de Cisteína Proteinase/química , Eletroforese em Gel de Poliacrilamida , Concentração de Íons de Hidrogênio , Focalização Isoelétrica , Espectrometria de Massas , Dados de Sequência Molecular , Concentração Osmolar , Homologia de Sequência de AminoácidosRESUMO
La infección osteoarticular (IOA) es una patología grave y secuelante, en la que el diagnóstico precoz cambia el curso de la enfermedad. El rendimiento del estudio microbiológico es variable (60-90 porciento) y depende de la localización de la infección, el tipo de muestra y los métodos microbiológicos utilizados. El objetivo de este estudio fue mejorar la confirmación bacteriológica mediante una solicitud ampliada de cultivos y de nuevas estrategias para el transporte e inoculación de las muestras. Se estudiaron los pacientes con sospecha de IAO mediante tinción de gram directa y cultivos aeróbico, en medio de thayer martin, anaeróbico, para hongos, micobacterias y hemocultivos. Todas las muestras de líquido sinovial se inocularon en tubos microbiológicos (becton dickinson) y las muestras de tejido obtenidas por punción bajo tomografía axial computada (tac) fueron innoculadas en botellas de hemocultivos (bact/aler@, organon teknica). Se estudiaron 86 pacientes de los cuales 51 correspondían al ioa. El rendimiento microbiológico global fue de 86 porciento, siendo más alto en osteomielitis aguda e infección de prótesis que en artritis séptica (88, 100 y 82 porciento respectivamente). Staphylococcus aureus fue el patógeno más prevalente, independiente del tipo de ioa, seguido de streptococcus pyogenes y streptococcus pneumoniae. La tinción de gram directa tuvo una sensibilidad de 57 porciento y en 5 pacientes cuyos cultivos fueron negativos, fue positiva. Los hemocultivos fueron positivos como método único en 6 pacientes. La sensibilidad del cultivo de tejido obtenido por punción bajo tac en botella de hemocultivo fue de 90 porciento. La posibilidad del cultivo de muestra de tejido óseo o sinovial fue mejor que la de líquido articular (92 versus 69 porciento) y la confirmación microbiológica global fue mejor en adultos que en niños (94 y 72 porciento respectivamente). Se concluye que la implementación de tubos microbiológicos y la inoculación directa en la botella de hemocultivo son métodos útiles para la recuperación bacteriana. La muestra de tejido debe ser recomendada antes que la de líquido articular y la tinción de gram y el hemocultivo deben ser considerados como métodos de gran aporte en la confirmación microbiológica de las IOA
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Adolescente , Adulto , Pessoa de Meia-Idade , Doenças Ósseas Infecciosas/microbiologia , Infecções Relacionadas à Prótese/microbiologia , Artrite Infecciosa/microbiologia , Infecções Bacterianas/etiologia , Líquido Sinovial/microbiologia , Osteomielite/microbiologiaRESUMO
Peptides present in a methanol extract prepared from skin of the Costa Rican frog Agalychnis callidryas of the Phyllomedusinae subfamily were studied by sequence analysis and pharmacological tests. Members of five different peptide families-tachykinins, bradykinins, caerulein, opioid peptides and sauvagine-were found. In particular, the extract contained a number of tachykinins with the following sequences: Gly-Pro-Pro-Asp-Pro-Asn-Lys-Phe-Ile-Gly-Leu-Met-NH2, Gly-Pro-Pro-Asp-Pro-Asp-Arg(Lys)-Phe-Tyr-Pro-Gly-Met-NH2, pGlu-Pro-Asp-Pro-Asp-Arg-Phe-Tyr-Pro-Gly-Met-NH2, Gly-Pro-Pro-Asp-Pro-Asn-Lys-Phe-Tyr-Pro-Val-Met. The latter three peptides have the unusual C-terminal sequence Pro-Gly(or Val)-Met-NH2 rather than Gly-Leu-Met-NH2 found in many other members of the tachykinin family. The observed amino acid substitutions may be the reason for the marked decrease in the biological activity observed in all in vitro and in vivo tests, even through the spectrum of tachykinin activities was retained. A kassinin-like peptide, with the sequence Gly-Pro-Pro-Asp-Pro-Asn-Lys-Phe-Ile-Gly-Leu-Met-NH2, was also found in the A. callidryas skin. While kassinin has a much higher affinity for NK-3 than for NK-1 receptors, the opposite is true for this A. callidryas peptide. The extract from A. callidryas skin also contained a new caerulein (pGlu-Asp-Tyr(HSO3)-Lys-Gly-Trp-Met-Asp-Phe-NH2) and a phyllokinin (Arg-Pro-Hyp-Gly-Phe-Ser-Pro-Phe-Arg-Ile-Tyr), as well as the opioid peptides dermorphin and [Hyp6]dermorphin, both previously isolated from different Phyllomedusa species.
Assuntos
Oligopeptídeos/química , Oligopeptídeos/isolamento & purificação , Pele/química , Taquicininas/química , Taquicininas/isolamento & purificação , Animais , Anuros , Bioensaio , Bradicinina/análogos & derivados , Bradicinina/química , Bradicinina/isolamento & purificação , Bradicinina/metabolismo , Ceruletídeo/análogos & derivados , Ceruletídeo/química , Ceruletídeo/isolamento & purificação , Ceruletídeo/metabolismo , Costa Rica , Cassinina/análogos & derivados , Cassinina/química , Cassinina/isolamento & purificação , Cassinina/metabolismo , Oligopeptídeos/metabolismo , Peptídeos Opioides , Taquicininas/metabolismoRESUMO
A novel 17 amino acid peptide, having a D-leucine in position 2 of its sequence, has been isolated from methanol extracts of the skin of the Brazilian frog, Phyllomedusa burmeisteri. The sequence of the peptide is: Tyr-D-Leu-Phe-Ala-Asp-Val-Ser-Thr-Ile-Gly-Asp-Phe-Phe-His-Ser-Ile-NH2. It displays a poor affinity for delta-opioid binding sites, both in the periphery and in the central nervous system. However, the shorter synthetic amidated analogue (1-10) possess both on the central and peripheral delta binding sites an agonistic potency equalling in affinity and exceeding in selectivity that of the enkephalins. The shorter amidated analogue (1-7) is virtually inactive on opioid binding sites in the periphery, but displays a clear-cut affinity for both delta and mu binding sites on rat brain membranes. To date six different D-amino acid residues have been found, always in position 2 of the sequence, in as many as 11 natural peptide molecules of animal origin.